title: Soft and Hard Tissue Response to Zirconia versus Titanium One-Piece Implants Placed in Alveolar and Palatal Sites: A Randomized Control Trial.
abstract: BACKGROUND
  Titanium (Ti) implants have been used in the last four decades to replace missing teeth. Alternatives to Ti such as zirconia (Zr) may offer aesthetic advantages and be more acceptable to patients and clinicians concerned about Ti allergy but must show equivalent biological acceptability to Ti.
  
  
  OBJECTIVE
  The research aimed to investigate soft and hard tissue response to Ti and Zr implants in edentulous patients.
  
  
  METHODS
  The research included 24 participants (Ti = 12, Zr = 12) restored with one-piece ball-abutment implants to support overdentures. Participants received four maxillary implants (two in the premolar alveolus, one off center in the alveolar midline, and one wide-diameter implant in the anterior median palate) and three mandibular implants (one in the midline and bilateral posterior implants).
  
  
  RESULTS
  Success rates for both Ti and Zr implants were low, 67.9% for all alveolar implants and a survival rate of 50.0% for the palatal implants. Only 11 (52.4%) of 21 palatal implants survived the follow-up period. Peri-implant health was equivalent for Ti and Zr implants and showed no statistically significant changes from loading to the 1-year follow-up. Statistically significant differences were noted in radiographic bone level between Ti and Zr implants (p = .02), with Zr showing greater bone loss.
  
  
  CONCLUSIONS
  Although the failure rates with the one-piece Zr implants were higher than with the Ti ones, suggesting that the former's clinical usage as in this study cannot be recommended, it should be borne in mind that the fault may also lie with the novel prosthodontic design which was used.
authors.affiliation: Department of Oral Sciences, Oral Implantology Research Group, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
authors.forename: Allauddin
authors.initials: A
authors.lastname: Siddiqi
authors.affiliation: Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
authors.forename: Jules August
authors.initials: JA
authors.lastname: Kieser
authors.affiliation: Sir John Walsh Research Institute, Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
authors.forename: Rohana Kumara
authors.initials: RK
authors.lastname: De Silva
authors.affiliation: Sir John Walsh Research Institute, Department of Oral Sciences, Discipline of Dental Public Health, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
authors.forename: William Murray
authors.initials: WM
authors.lastname: Thomson
authors.affiliation: Sir John Walsh Research Institute, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
authors.forename: Warwick John
authors.initials: WJ
authors.lastname: Duncan
mesh_terms: D000368:Aged; D054893:Cone-Beam Computed Tomography; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003828:Denture, Overlay; D004955:Esthetics, Dental; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009066:Mouth, Edentulous / Q000534:rehabilitation*; D013499:Surface Properties; D014025:Titanium / Q000737:chemistry*; D016896:Treatment Outcome; D015040:Zirconium / Q000737:chemistry*
chemical_list: D015921:Dental Implants; D015040:Zirconium; D014025:Titanium; C028541:zirconium oxide
keywords: crestal bone loss; edentulous mandible; edentulous maxilla; randomized controlled trial; success rate; survival rate; titanium; zirconia